The National Cancer Institute developed the Family Life, Activity, Sun, Health, and Eating (FLASHE) Study to examine multiple cancer preventive behaviors within parent–adolescent dyads. The purpose ...of creating FLASHE was to enable the examination of physical activity, diet, and other cancer preventive behaviors and potential correlates among parent–adolescent dyads. FLASHE surveys were developed from a process involving literature reviews, scientific input from experts in the field, cognitive testing, and usability testing. This cross-sectional, web-based study of parents and their adolescent children (aged 12–17 years) was administered between April and October 2014. The nationwide sample consisted of 1,573 parent–adolescent dyads (1,699 parents and 1,581 adolescents) who returned all FLASHE surveys. FLASHE assessed parent and adolescent reports of several intrapersonal and interpersonal domains (including psychosocial variables, parenting, and the community and home environments). On a subset of example FLASHE items across these domains, responses of parents and adolescents within the same dyads were positively and significantly correlated ( r =0.32–0.63). Analyses were run in 2015–2016. FLASHE data present multiple opportunities for studying research questions among individuals or dyads, including the ability to examine similarity between parents and adolescents on many constructs relevant to cancer preventive behaviors. FLASHE data are publicly available for researchers and practitioners to help advance research on cancer preventive health behaviors.
Objective To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Data Sources Systematic literature ...searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Study Inclusion and Exclusion Criteria Articles published in scientific journals were included if they evaluated an intervention for physical activity and/or dietary behaviors, or focused on weight loss, used randomized or quasi-experimental designs, measured outcomes at baseline and a follow-up period, and included an intervention where participants interacted with some type of electronic technology either as the main intervention or an adjunct component. All studies were published between 2000 and 2005. Results Eighty-six publications were initially identified, of which 49 met the inclusion criteria (13 physical activity publications, 16 dietary behaviors publications, and 20 weight loss or both physical activity and diet publications), and represented 47 different studies. Studies were described on multiple dimensions, including sample characteristics, design, intervention, measures, and results. eHealth interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Conclusions Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.
Introduction In 2014, the National Cancer Institute conducted the Family Life, Activity, Sun, Health, and Eating Study (FLASHE). This parent and adolescent survey examines psychosocial; generational ...(parent–adolescent); and environmental (home and neighborhood) correlates of cancer-preventive behaviors, with a particular emphasis on diet and physical activity. This paper describes the FLASHE data collection methods and enrollment and response rates. Methods FLASHE data collection methods included web-based surveys delivered to dyads of parents and their adolescent children, and deployment of accelerometers to a subset of adolescents, to achieve study goals in a nationwide study sample. The National Cancer Institute contracted with Westat, Inc. to recruit, enroll, and collect the data using a consumer opinion panel. Results A total of 5,027 dyads were screened for eligibility, and 1,945 (38.7%) enrolled. Of fully enrolled dyads, 85.6% of those in the Survey-Only group completed all four surveys, and 58.7% of dyads in the Motion Study group completed all surveys and were compliant with the accelerometer protocol for adolescents. The overall study response rate was 29.4%; 1,479 dyads completed all study procedures. The majority of parents were female, whereas the adolescent sample was gender balanced. Data were analyzed in 2015–2016. Conclusions FLASHE recruited a large sample of parent–adolescent dyads. Although challenges for research in parent–adolescent dyads include enrolling a diverse sample and having multistep enrollment and consent processes, study completion rate was high among fully enrolled dyads. Future panel studies may consider approaches used in FLASHE to encourage study enrollment and completion.
Abstract Background Fruit and vegetable (F/V) intake assessment tools that are valid, reliable, brief, and easy to administer and code are vital to the field of public health nutrition. Objective To ...evaluate three short F/V intake screeners (ie, a 2-item serving tool, a 2-item cup tool, and a 16-item F/V intake screener) among adults using multiple 24-hour dietary recalls (24-hour recalls) as the reference instrument and evaluate test–retest reliability of the screeners across a 2- to 3-week time period. Design Validity and reliability study. Participants/setting Two hundred forty-four adults for the validity study and 335 adults for test–retest reliability. Statistical analyses performed Median values for F/V intakes were calculated for the screeners and 24-hour recalls. The Wilcoxon signed rank test was used to compare screeners with the 24-hour recalls. Deattenuated Pearson correlations were reported for validity and intraclass correlation coefficient used for reliability. Results The estimated median daily servings/cups of F/V for the 2-item serving screener was lower, for the 2-item cup screener was equivalent for men but higher for women, and for the 16-item F/V intake screener were about the same when compared with 24-hour recall values. The deattenuated correlations comparing the 24-hour recalls with the screeners were positive but weak for the 2-item serving screener, and were positive and moderate in strength for the 2-item cup and 16-item F/V intake screeners. The test–retest intraclass correlation coefficients were all positive and fairly strong for all of the screeners. Conclusions Although dietary screeners offer a more cost-effective, less burdensome way to obtain gross estimates to rank individuals with regard to F/V intake, these methods are not recommended for assessing precise intake levels.
Abstract Objective This review describes available measures of retail food store environments, including data collection methods, characteristics of measures, the dimensions most commonly captured ...across methods, and their strengths and limitations. Methods Articles were included if they were published between 1990 and 2015 in an English-language peer-reviewed journal and presented original research findings on the development and/or use of a measure or method to assess retail food store environments. Four sources were used, including literature databases, backward searching of identified articles, published reviews, and measurement registries. Results From 3,013 citations identified, 125 observational studies and 5 studies that used sales records were reviewed in-depth. Most studies were cross-sectional and based in the US. The most common tools used were the US Department of Agriculture's Thrifty Food Plan and the Nutrition Environment Measures Survey for Stores. The most common attribute captured was availability of healthful options, followed by price. Measurement quality indicators were minimal and focused mainly on assessments of reliability. Implications for Research and Practice Two widely used tools to measure retail food store environments are available and can be refined and adapted. Standardization of measurement across studies and reports of measurement quality (eg, reliability, validity) may better inform practice and policy changes.
Introduction The National Cancer Institute’s 2014 Family Life, Activity, Sun, Health, and Eating Study utilized a 27-item Dietary Screener tailored to adolescent eating patterns that assessed the ...frequency of intake of several foods and beverages in parent–adolescent dyads. This study estimated intake of fruits and vegetables (FVs), dairy, added sugars, and whole grains for screener respondents using existing, nationally representative, 24-hour dietary recall data. Methods Dietary Screener items were converted from frequency responses to daily intake. Intake (dependent variable) was estimated using regression coefficients and portion sizes of foods and beverages (independent variables) generated from the 2003–2006 National Health and Nutrition Examination Survey 2-day 24-hour recall data set. Means (SDs) were used to examine daily dietary factor intake among parent and adolescents. Analysis was conducted in 2015–2016. The analytic sample consisted of 1,732 parents (aged ≥18 years) and their adolescent aged 12–17 years ( n =1,632). Results Male parents consumed 3.6 cups of FVs, 1.8 cups of dairy, 22.6 teaspoons of added sugars, and 2.1 ounces of whole grains daily; female parents consumed 2.8 cups of FVs, 1.3 cups of dairy, 14.8 teaspoons of added sugars, and 1.4 ounces of whole grains daily. Male adolescents consumed 2.2 cups of FVs, 1.9 cups of dairy, 17.9 teaspoons of added sugars, and 1.0 ounces of whole grains daily; female adolescents consumed 2.2 cups FVs, 1.6 cups of dairy, 14.2 teaspoons of added sugars, and 0.8 ounces of whole grains daily. Conclusions Utilizing a dietary screener tailored to adolescent eating patterns in parent–adolescent dyads provided estimated dietary factor intake, underscoring existing 24-hour dietary recall data can be used to calibrate dietary habits.
Introduction It is unclear whether Supplemental Nutrition Assistance Program (SNAP) or National School Lunch Program (NSLP) participation modifies the relationship between food insecurity and obesity ...in children. Methods Data were included for 4,719 children aged 9–17 years who participated in the National Health and Nutrition Survey between 2003–2004 and 2011–2012. Linear regression was used to examine the relationship between household food security (full, marginal, low, and very low) and BMI percentile. Adjusted models were also stratified by SNAP and NSLP participation. Results There was no significant overall relationship between household food security and BMI percentile. In SNAP non-participants, there was no apparent overall relationship between BMI percentile and household food security. However, BMI percentile in children from households with low food security was significantly higher than that of children from fully food-secure households (risk difference RD=5.95, 95% CI=1.11, 10.80). Among SNAP participants, there was no significant relationship between household food security and BMI percentile. By NSLP participation category, there was a non-significant trend toward increasing BMI percentile with decreasing household food security in those reporting two or fewer (RD=1.75, 95% CI= –0.79, 4.29) and two to three (RD=1.07; 95% CI= –1.74, 3.89) lunches/week. There was no apparent relationship between household food security and BMI percentile in those reporting four or more lunches/week. Conclusions Although the overall relationship between household food security and weight status in school-aged children was not statistically significant, there was some evidence that the relationship may differ by SNAP or NSLP participation, suggesting the need for more research.
Abstract The recent revisions of the National School Lunch Program (NSLP) requirements are designed to align with the 2010 Dietary Guidelines for Americans. The introduction and implementation of the ...new NSLP has been received with positive and negative reactions from school food professionals, students, parents, and teachers. To promote student health, this is an important time for policy makers, practitioners, and researchers to implement and evaluate strategies to support the new NSLP guidelines. The purpose of this viewpoint was to outline the new NSLP guidelines and discuss challenges and opportunities for implementation, strategies for practice, and future research questions.
Abstract Objective To examine the relationship between economic time preferences and frequency of fast food and full-service restaurant consumption among U.S. adults. Methods Participants included ...5871 U.S. adults who responded to a survey conducted in 2011 pertaining to the lifestyle behaviors of families and the social context of these behaviors. The primary independent variable was a measure of time preferences, an intertemporal choice assessing delay discounting. This was elicited via responses to preferences for an immediate dollar amount or a larger sum in 30 (30-day time horizon) or 60 days (60-day time horizon). Outcomes were the frequency of fast food and full-service restaurant consumption. Ordered logistic regression was performed to examine the relationship between time preferences and food consumption while adjusting for covariates (e.g. socio-demographics). Results Multivariable analysis revealed that higher future time preferences were significantly related to less frequent fast food intake for both the 30- and 60-day time horizon variables (P for linear trend < 0.05; both). Notably, participants with the highest future time preference were significantly less likely to consume fast food than those with very low future time preferences (30-day: OR = 0.74, 95%CI: 0.62–0.89; and 60-day: OR = 0.86, 95%CI: 0.74–1.00). In comparison, higher future time preferences were not significantly associated with full-service restaurant intake (30-day: p for linear trend = 0.73; 60-day: p for linear trend = 0.83). Conclusions Higher future time preferences were related to a lower frequency of fast food consumption. Utilizing concepts from behavioral economics (e.g. pre-commitment contracts) to facilitate more healthful eating is warranted using experimental studies.
In the past 5 years, there have been notable strides toward the earlier recognition and discovery of melanoma, including new technologies to complement and augment the clinical examination and new ...insights to help clinicians recognize early melanoma. However, incidence and mortality rates throughout most of the developed world have risen over the past 25 years, while education and screening, potentially the best means for reducing the disease, continue to be severely underutilized. Much progress needs to be made to reach middle-aged and older men and persons of lower socioeconomic status who suffer a disproportionate burden of death from melanoma. Worldwide melanoma control must also be a priority, and comprehensive educational and screening programs should be directed to Northern Ireland and a number of Eastern European nations, whose 5-year survival rates range between 53% and 60%, mirroring those of the United States and Australia more than 40 years ago. Learning objective After completing this learning activity, participants should be aware of the most recent melanoma epidemiologic data, both in the United States and internationally; worldwide early detection and screening programs; clinical strategies to recognize and improve the detection of early melanoma; the latest technologies for early detection of melanoma; and public and professional education programs designed to enhance early detection.
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